Empowering people living with HIV (PLHIV): unveiling care gaps and identifying opportunities for improving care for PLHIV in Singapore and Hong Kong.

INTRODUCTION: This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. METHODS: This qualitative study involved 90-minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health-related quality of life perceptions and gaps in patient empowerment in HIV care during February-May 2022. The COM-B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents' experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. RESULTS: A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20-49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long-term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. CONCLUSIONS: There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing.

Correlation of the activities of antioxidant enzymes superoxide dismutase and glutathione reductase with micronuclei counts among areca nut chewers of Manipuri population using exfoliative cytology: A preliminary study.

Context: Areca nut (AN) is a potent cytotoxic and genotoxic agent. Oxidative stress-induced by chewing of AN can cause DNA damage leading to nuclear anomalies such as micronuclei (MN) and also alters antioxidant defense mechanisms, leading to genomic instabilities and the development of oral cancer. Aims: The aim of this study is to study the correlation between the levels of glutathione reductase (GR) and superoxide dismutase (SOD) in exfoliated buccal mucosal cells and the genotoxicity levels (MN count) in chronic AN chewers. Materials and Methods: The present study was conducted with the approval of the Research Ethics Board in 60 individuals; 40 cases (Group I-20 raw AN chewers, Group II-20 dried areca with tobacco chewers), and 20 controls as Group III in the age group of 18-68 years who attended the outpatient department of our college. Estimation of SOD and GR and MN assessment was done using buccal exfoliated cells. Statistical Analysis Used: Statistical analysis was performed using the Student's t-test and one-way ANOVA. Results: Antioxidant levels were found to be significantly reduced in both Group I and Group II in comparison to the control group. Group II showed significantly reduced level of GR in comparison to Group I. The MN count was significantly increased in Group II in comparison to Group I. The MN counts showed an inverse correlation to the activities of the antioxidant enzymes. Greater activities of antioxidant enzymes correlated with decreased MN counts. Conclusions: Detection of MN in AN chewers with or without tobacco can be a useful biomarker for clinical screening procedures that may be used as a risk marker for oral cancer. It is important to increase the awareness programs to educate the public about the deleterious effects of AN chewing, emphasize on early intervention of AN chewing habit and thus prevent the development of oral cancer.

Impact of COVID-19 on the HIV care continuum in Asia: Insights from people living with HIV, key populations, and HIV healthcare providers.

BACKGROUND: The COVID-19 pandemic has threatened continued access to public health services worldwide, including HIV prevention and care. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV service access and delivery in the Asia region. METHODS: A descriptive, cross-sectional, online study, conducted between October-November 2020, assessed the impact of COVID-19 on HIV prevention and care among people living with HIV (PLHIV), key populations (KPs), and healthcare providers (HCPs). The study populations were recruited across ten Asian countries/territories, covering Hong Kong, India, Japan, Malaysia, Philippines, Singapore, Korea, Taiwan, Thailand, and Vietnam. RESULTS: Across the region, 702 PLHIV, 551 KPs, and 145 HCPs were recruited. Both PLHIV and KPs reported decreased or had yet to visit hospitals/clinics (PLHIV: 35.9%; KPs: 57.5%), reduced HIV RNA viral load testing (21.9%; 47.3%), and interruptions in antiretroviral therapy (ART) (22.3%) or decreased/complete stop of HIV prevention medication consumption (40.9%). Travel constraints (40.6%), financial issues (28.9%), and not receiving prescription refills (26.9%) were common reasons for interrupted ART access, whereas reduced engagements in behaviours that could increase the risks of HIV acquisition and transmission (57.7%), travel constraints (41.8%), and less hospital/clinic visits (36.7%) underlie the disruptions in HIV preventive medications. Decreased visits from PLHIV/KPs and rescheduled appointments due to clinic closure were respectively reported by 50.7%-52.1% and 15.6%-17.0% of HCPs; 43.6%-61.9% observed decreased ART/preventive medication refills. Although 85.0% of HCPs adopted telemedicine to deliver HIV care services, 56.4%-64.1% of PLHIV/KPs were not using telehealth services. CONCLUSIONS: The COVID-19 pandemic substantially disrupted HIV prevention to care continuum in Asia at the time of the study. The findings highlighted differences in HIV prevention to care continuum via telehealth services utilisation by PLHIV, KPs, and HCPs. Efforts are needed to optimise infrastructure and adapt systems for continued HIV care with minimal disruptions during health emergency crises.

Effect of a Popular Web Drama Video Series on HIV and Other Sexually Transmitted Infection Testing Among Gay, Bisexual, and Other Men Who Have Sex With Men in Singapore: Community-Based, Pragmatic, Randomized Controlled Trial.

BACKGROUND: Gay, bisexual, and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of a variety of community-based campaigns, including peer and reminder-based interventions on HIV/STI testing, however few have attempted to do so for a web drama series. OBJECTIVE: This study evaluates the effectiveness of a popular web drama video series developed by a community-based organization in Singapore for GBMSM on HIV and other STI testing behaviors. METHODS: The study is a pragmatic, randomized controlled trial to evaluate a popular web drama video series developed by a community-based organization in Singapore for GBMSM. A total of 300 HIV-negative, GBMSM men in Singapore aged 18 to 29 years old were recruited and block-randomized into the intervention (n=150) and control arms (n=150). Primary outcomes included changes in self-reported intention to test for, actual testing for, and regularity of testing for HIV, syphilis, chlamydia or gonorrhea, while secondary outcomes include changes in a variety of other knowledge-based and psychosocial measures at the end of the study period. RESULTS: Overall, 83.3% (125/150) of participants in the intervention arm completed the proof of completion survey, compared to 88.7% (133/150) in the control arm. We found improvements in self-reporting as a regular (at least yearly) tester for HIV (15.9% difference, 95% CI, 3.2% to 28.6%; P=.02), as well as chlamydia or gonorrhea (15.5% difference, 95% CI, 4.2% to 26.9%; P=.009), indicating that the intervention had positively impacted these outcomes compared to the control condition. We also found improvements in participants' intentions to test for HIV (16.6% difference, 95% CI, 4.3% to 28.9%; P=.009), syphilis (14.8% difference, 95% CI, 3.2% to 26.4%; P=.01), as well as chlamydia or gonorrhea (15.4% difference, 95% CI, 4.2% to 26.6%; P=.008), in the next 3 months, indicating that the intervention was effective in positively impacting intention for HIV and other STI testing among participants. CONCLUSIONS: There are clear benefits for promoting intentions to test regularly and prospectively on a broad scale through this intervention. This intervention also has potential to reach GBMSM who may not have access to conventional HIV and other STI prevention messaging, which have typically been implemented at sex-on-premises venues, bars, clubs, and in sexual health settings frequented by GBMSM. When coupled with community or population-wide structural interventions, the overall impact on testing will likely be significant. TRIAL REGISTRATION: ClinicalTrials.gov NCT04021953; https://clinicaltrials.gov/ct2/show/NCT04021953. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2019-033855.

Fibrolipoma of the Buccal Mucosa in a Geriatric Patient.

Lipoma is the most common mesenchymal tumor seen in the trunk and extremities. It is rarely found in the mouth. Clinically, it resembles other lesions and is not considered in the initial diagnosis. Histopathological evaluation is needed for accurate diagnosis. Surgical excision is the main treatment modality. Histologically, many variants are described of which fibrolipoma is thought to have some recurrence. This article describes a case of fibrolipoma of the buccal mucosa in a geriatric patient.

Microscopic Assessment of Dentinal Defects Induced by ProTaper Universal, ProTaper Gold, and Hyflex Electric Discharge Machining Rotary File Systems - An in vitro Study.

BACKGROUND: Biomechanical preparation of root canal can damage root dentin leading to the formation of dentinal cracks which can eventually lead to fracture and failure of the treatment. AIM: The aim was to investigate the incidence of dentinal defects in root canals prepared with ProTaper Universal, ProTaper Gold, and Hyflex electric discharge machining (EDM) rotary file systems using handheld USB digital microscope. MATERIALS AND METHODS: One hundred and fifty extracted mandibular premolar teeth with single canal were randomly divided into five groups (n = 30). Group 1: unprepared (negative control). Group 2: canal preparation done with nickel-titanium hand files (positive control), Group 3: canals prepared with ProTaper Universal rotary system, Group 4: canal preparation done with ProTaper Gold rotary system, and Group 5: canals prepared with Hyflex EDM rotary system. The specimens were sliced at 3 mm, 6 mm, and 9 mm from the apex with a slow-speed saw under water cooling. Digital images of each section were captured at ×40 magnification with the aid of a microscope. Two independent evaluators assessed the images for the presence of dentinal defects. The number of dentinal defects was recorded and Chi-square test was used for statistical analysis (P < 0.05). RESULTS: The number of specimens presenting dentinal defects was as follows: Group 3; ProTaper Universal - 9/30 (30.0%), Group 4; ProTaper Gold - 2/30 (6.7%), and Group 5; Hyflex EDM - 1/30 (3.3%). No defects were detected in the negative and positive control groups (Group 1 and Group 2). CONCLUSION: ProTaper Universal showed the highest percentage of defects in comparison to ProTaper Gold and Hyflex EDM.

Experienced Homophobia and Suicide Among Young Gay, Bisexual, Transgender, and Queer Men in Singapore: Exploring the Mediating Role of Depression Severity, Self-Esteem, and Outness in the Pink Carpet Y Cohort Study.

Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender, and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men in Singapore. Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study, Singapore's first prospective cohort study among young GBTQ men. The sample comprised 570 young GBTQ men 18 to 25 years of age who were HIV negative or unsure of their HIV status. Statistical analyses were conducted through descriptive statistics, multivariable logistic regression, and structural equation modeling techniques. Results: Of 570 participants, 58.9% (n = 308) reported ever contemplating suicide, whereas 14.2% (n = 76) had ever attempted suicide. Controlling for key demographic variables, multivariable logistic regression revealed that experienced homophobia and depression severity were positively associated with a history of suicidal ideation, whereas depression severity and outness were positively associated with a history of suicide attempts. Mediation analyses revealed that depression severity and self-esteem partially accounted for the relationship between experienced homophobia and suicidal ideation, whereas depression severity and outness partially accounted for the relationship with suicide attempts. Conclusions: The prevalence of suicidal ideation and past suicide attempts was found to be high in a sample of young GBTQ men in Singapore. Interventions to address experienced homophobia and discrimination among young GBTQ men are needed urgently in Singapore.

Delineating patterns of sexualized substance use and its association with sexual and mental health outcomes among young gay, bisexual and other men who have sex with men in Singapore: a latent class analysis.

BACKGROUND: Young gay, bisexual, and other men who have sex with men (YMSM) are vulnerable to the risks associated with sexualized substance use. This is a novel study in Singapore that aims to classify patterns of sexualized substance use among YMSM, and investigate its association with sexual and mental health outcomes. METHODS: In this cross-sectional study among 570 YMSM aged 18 to 25 years old, latent class analysis (LCA) conducted to identify classes with similar patterns of sexualized substance use, across which measures of inconsistent condom use, recent STI diagnoses, past suicide ideation and depression severity were compared. RESULTS: LCA revealed three classes of YMSM based on types of substances ever used in sexualized contexts, which we labelled as 'substance-naive', 'substance-novice', and 'chemsex'. Substance-naive participants (n = 404) had only ever used alcohol, while substance-novice participants (n = 143) were primarily amyl nitrite users with a small proportion who reported using chemsex-related drugs. Chemsex participants (n = 23) comprised individuals who had mostly used such drugs. Those in the chemsex group were more likely to report recent unprotected anal sex with casual partners (aPR = 3.28, 95%CI [1.85, 5.79]), depression severity (aß = 3.69, 95%CI [0.87, 6.51]) and a history of suicide ideation (aPR = 1.64, 95%CI [1.33, 2.03]). CONCLUSIONS: Findings of this study highlight how the use of varying substances in sexualized contexts may be classified and characterized by different sexual and mental health outcomes. Health promotion efforts should be differentiated accordingly to address the risks associated with sexualized substance use among YMSM.

Association between sexual orientation acceptance and suicidal ideation, substance use, and internalised homophobia amongst the pink carpet Y cohort study of young gay, bisexual, and queer men in Singapore.

BACKGROUND: Gay, bisexual and queer (GBQ) men are frequently subjected to minority stressors that have negative impacts on their health. Milestones that include the acceptance and disclosure of sexual identity amongst GBQ men are hence key instruments in understanding the prevalence of internalised homophobia and predicting health outcomes. As such, this work takes a novel approach to deduce the correlates of delayed acceptance of sexual orientation in young GBQ men as a measure of internalised homophobia through retrospective self-reporting and age-based analysis. METHODS: Participants were recruited as part of a cohort study exploring the syndemic risks associated with HIV acquisition among young GBQ men in Singapore. We examined their levels of internalised, perceived, experienced homophobia, as well as their health behaviours and suicidal tendencies. Two separate variables were also self-reported by the participants - the age of questioning of sexual orientation and the age of acceptance of sexual orientation. We subsequently recoded a new variable, delayed acceptance of sexual orientation, by taking the difference between these two variables, regressing it as an independent and dependent variable to deduce its psychosocial correlates, as well as its association with other measured instruments of health. RESULTS: As a dependent variable, delayed acceptance of sexual orientation is positively associated with an increase of age and internalised homophobia, while being negatively associated with reporting as being gay, compared to being bisexual or queer. As an independent variable, delayed acceptance of sexual orientation was associated with a delayed age of coming out to siblings and parents, suicide ideation, historical use of substances including smoking tobacco cigarettes and consuming marijuana, as well as reporting higher levels of experienced, internalised and perceived homophobia. CONCLUSION: Greater levels of early intervention and efforts are required to reduce the heightened experience of minority stress resulting from communal and institutional hostilities. Areas of improvement may include community-based counselling and psychological support for GBQ men, while not forsaking greater education of the social and healthcare sectors. Most importantly, disrupting the stigma narrative of a GBQ 'lifestyle' is paramount in establishing an accepting social environment that reduces the health disparity faced by GBQ men.

Crafting a Community Blueprint towards ending HIV transmission and AIDS in Singapore by 2030.

In November 2019, Action for AIDS launched the Community Blueprint Towards Ending HIV and AIDS in Singapore by 2030, a key milestone in the country's HIV movement where a roadmap was developed with strategies to end HIV by 2030. Overall, 60 representatives from 30 community organisations and institutions were convened to plan and lead work on the Blueprint, which covers 10 themes. The Blueprint examines the current state of the epidemic and populations most affected by it: heterosexual males with multiple partners, men who have sex with men, sex workers, transgender persons, and persons who use drugs. It assesses existing programs, estimates gaps and recommends strategies and resources needed to close the gap. The second section of the Blueprint explores cross-cutting themes including: stigma and discrimination; strengthening the HIV community workforce; and scaling up pre-exposure prophylaxis. The Blueprint provides key recommendations and is being discussed with the Ministry of Health.

Social capital and chemsex initiation in young gay, bisexual, and other men who have sex with men: the pink carpet Y cohort study.

BACKGROUND: Young gay, bisexual, and other men who have sex with men (YMSM) are especially vulnerable to the risks associated with sexualized substance use, or 'chemsex'. Engaging in chemsex established as a major risk factor for Human Immunodeficiency Virus (HIV) acquisition, and is thus a public health issue of increasing urgency. This paper attempts to explore the association between measures of social capital and patterns of sexualized substance use among a sample of YMSM in Singapore. METHODS: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study in Singapore, comprising a sample of 570 HIV-negative YMSM aged 18 to 25 years old. Latent class analysis was employed to identify classes with similar patterns of sexualized substance use, and multinomial logistic regression was employed to examine associations between class membership and proxy measures of social capital, including age of sexual debut, bonding and bridging social capital, connectedness to the lesbian, gay, bisexual and transgender community, and outness. RESULTS: Latent class analysis revealed three classes of YMSM based on their histories of sexualized substance use, which we labelled as 'alcohol', 'poppers', and 'chemsex'. Multivariable analyses revealed that participants who were older (aOR = 1.19, p = 0.002) and who identified as gay (aOR = 2.43, p = 0.002) were more likely to be in the poppers class compared to the alcohol class. Participants with a later age of sexual debut were increasingly less likely to be in the poppers (aOR = 0.93, p = 0.039) and chemsex classes (aOR = 0.85, p = 0.018), compared to the alcohol class. CONCLUSIONS: Varying measures of social capital such as an earlier age of exposure to sexual networks may predispose YMSM to greater opportunities for sexualized substance use. Future interventions should target YMSM who become sexually active at an earlier age to reduce the risks associated with sexualized substance use.

Comparative Evaluation of Mitochondrial Antioxidants in Oral Potentially Malignant Disorders.

Various endogenous mitochondria-associated antioxidants protect mitochondria from oxidative stresses such as Superoxide Dismutase 2 (SOD2), Catalase, Glutaredoxin 2 (GLRX2), educed Glutathione (GSH), Glutathione Peroxidase (GPx), and Thioredoxin 2 (TXN2). They protect mitochondria from Reactive Oxygen Species (ROS). Excess ROS causes mitochondrial DNA damage and respiratory chain dysfunction leading to carcinogenesis. In an earlier study we found complex alterations of mitochondrial antioxidants in different stages of oral squamous cell carcinoma. Here, we profiled mitochondrial antioxidants in different oral potentially malignant disorders such as oral leukoplakia (OL), oral lichen planus (OLP), and oral submucous fibrosis (OSMF). Mitochondria was prepared from oral tissues from OL, OLP, and OSMF patients. Biochemical assays and immunoblotting were performed to investigate expression of various mitochondrial antioxidants. Catalase was expressed as Control> OL > OSMF > OLP. GLRX 2 was expressed as OLP> OL >Control >OSMF. GPX1 and GPX4 were expressed as Control >OSMF> OLP > OL. GSH increased in OL and OSMP, but decreased in OLP. SOD2 was expressed as Control >OSMF> OLP > OL. PRX3 was expressed as OL > OLP > OSMF > Control. TXN2 expression was nearly the same in all groups except OL, which showed elevated expression. We conclude that endogenous mitochondria-associated antioxidants show different levels of expressions in various oral potentially malignant disorders.

Effect of a web drama video series on HIV and other sexually transmitted infection testing among gay, bisexual and queer men: study protocol for a community-based, pragmatic randomised controlled trial in Singapore: the People Like Us (PLU) Evaluation Study.

INTRODUCTION: Gay, bisexual and queer (GBQ) men are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBQ men are increasing worldwide, they remain suboptimal in a variety of settings. METHODS AND ANALYSIS: The study is a pragmatic randomised controlled trial designed to evaluate an online video series developed by a community-based organisation in Singapore for GBQ men. A total of 300 HIV-negative GBQ men in Singapore aged 18-29 years old will be recruited for this study. Participants will subsequently be randomised into the intervention arm (n=150) and the control arm (n=150). The intervention arm (n=150) will be assigned the intervention along with sexual health information via a pamphlet, while the control group (n=150) will be assigned only the sexual health information via a pamphlet. Participants should also not have watched the video prior to their participation in this study, which will be ascertained through a questionnaire. Primary outcomes for this evaluation are changes in self-reported intention to test for, actual testing for and regularity of testing for HIV, syphilis, chlamydia and gonorrhoea at the 3 and 6 months after intervention. Secondary outcomes include changes in self-reported risk perception for HIV and other STIs, knowledge of HIV, knowledge of risks associated with acquiring STIs, knowledge of HIV pre-exposure prophylaxis, consistent condom use for anal sex with casual partners, incidence of STIs, connectedness to the lesbian, gay, bisexual and transgender community, self-concealment of sexual orientation, perceived homophobia, internalised homophobia, HIV testing self-efficacy and HIV testing social norms. ETHICS AND DISSEMINATION: The study has been approved by the National University of Singapore Institutional Review Board (S-19-059) and registered at ClinicalTrials.gov. The results will be published in peer-reviewed academic journals and disseminated to community-based organisations and policymakers. TRIAL REGISTRATION NUMBER: NCT04021953.

In vitro degradation of ß-amyloid fibrils by microbial keratinase.

INTRODUCTION: Amyloid fibrils are misfolded, protease-resistant forms of normal proteins. They are infectious such as prions or noninfectious such as ß-amyloid (Aß) fibrils causing Alzheimer's disease (AD). Prions and amyloids are structurally similar, possessing cross ß-pleated sheet-like structures. As microbial keratinase could degrade prions, we tested keratinase activity on Aß fibrils. METHODS: Lysozyme treated with urea generates Aß fibrils demonstrated by immunoblotting with anti-Aß antibody, high-performance liquid chromatography, and Congo red absorption spectroscopy. Two keratinases, Ker1 and Ker2, were purified from an actinomycete Amycolatopsis sp. MBRL 40 and incubated with Aß fibrils. RESULTS: Soluble Ker1 and Ker1 reconstituted on neutral/cationic liposomes degraded Aß fibrils efficiently. Ker 2 was less potent. DISCUSSION: Drugs that target AD inhibit acetylcholinesterase or formation of Aß fibrils and downstream effects. These drugs have side effects and do not benefit globally in cognition. Keratinases are novel molecules for drug development against AD.

Altered expression of mitochondrial antioxidants in oral squamous cell carcinoma.

Reactive oxygen species, if produced in excess by oxidative phosphorylation, contributes to mitochondrial DNA damage and progressive respiratory chain dysfunction, leading to various diseases including carcinogenesis. Mitochondria are susceptible to oxidative stress (OS) owing to lack of introns, protective histones, and DNA repair enzymes. However, mitochondria are protected from OS by numerous antioxidants such as superoxide dismutase 2 (SOD2), catalase, glutaredoxin 2 (GLRX2), reduced glutathione (GSH), glutathione peroxidase (GPX), and thioredoxin 2 (TXN2). To obtain insights regarding expression of these mitochondrial antioxidants in oral squamous cell carcinoma (OSCC), we performed qualitative and quantitative estimations of key molecular players of mitochondrial antioxidants during various stages of OSCC by immunoblotting with specific antibodies against antioxidant enzymes and/or biochemical assays. Different mitochondrial antioxidants varied in their expression levels as OSCC progressed. The levels of GPX1, GPX4, and catalase reduced with progression of OSCC. However, GLRX2, PXR3, TXN2, and reduced GSH gradually increased. Expression of SOD2 decreased initially in Stages II and III of OSCC but increased in Stage IV. In conclusion, our findings indicate a complex interplay of various mitochondrial antioxidants in different stages of OSCC, and further insights regarding these molecular players can help us better understand the pathogenesis of OSCC in context of mitochondrial redox status.

Evaluation of Histomorphometric Changes in Tissue Architecture in Relation to Alteration in Fixation Protocol - An Invitro Study.

INTRODUCTION: Preparation of good tissue specimens for microscopy requires complete fixation. No ideal fixative has been found till date, with every fixative showing advantages and disadvantages. Appropriate fixation is required to maintain clear and consistent morphologic features for histologic examination. Pathologists mostly examine formalin fixed tissue sections and are less used to the morphologic changes induced by other fixatives. Underfixed and overfixed tissue in various fixatives can lead to tissue architectural changes which can affect its diagnostic value. AIM: To assess sectioning ability, staining intensity and microscopic details of tissues kept in different fixatives at different time intervals. MATERIALS AND METHODS: Fresh tissue specimen i.e., goat tongue was collected and its middle-third portion was used for the study purpose. The tissue was grossed into 10 equal pieces and kept in various fixatives (10% Buffered formalin, Carnoy's solution, Absolute ethyl alcohol, Bouin's fluid) for five different time intervals (6, 12, 18, 24 and 30 hours) and normal tissue processing steps were carried out followed by sectioning and staining. During sectioning, sectioning parameter was assessed. Following sectioning, sections were observed under light microscope and were histologically evaluated for staining and microscopic details. To calculate the sectioning parameter Fisher's exact test was used and to assess parameters for staining and microscopic details Mann-Whitney U test was used. RESULTS: According to the study, 10% buffered formaldehyde is considered as a superior fixative under all parameters followed by Bouin's fluid, Carnoy's solution and Absolute alcohol. CONCLUSION: In our study, it was concluded that 10% buffered formaldehyde should be continued as a routine fixative however, other fixatives can be used depending upon the non-availability of required fixative or in case of emergencies. Pathologist should be accustomed to histologic and morphologic changes of underfixed and overfixed tissue which can affect its diagnostic value.

White sponge nevus: Report of three cases in a single family.

White sponge nevus (WSN) is an interesting hereditary oral mucosal disorder that commonly manifests as bilaterally symmetrical, thickened white, corrugated or velvety, diffuse plaques that predominantly affects the buccal mucosa. The lesions may develop at birth or later in childhood or adolescence. Because it is asymptomatic and benign, WSN requires no treatment. Recognition of this disorder is important due to its potential confusion with other lesions that may be found in the oral cavity. Emphasis should be given to the early and correct diagnosis of this disorder to avoid unnecessary treatment. This report presents three affected members of a single family.

Analysis of the Genotoxic Effects of Mobile Phone Radiation using Buccal Micronucleus Assay: A Comparative Evaluation.

INTRODUCTION: Micronucleus (MN) is considered to be a reliable marker for genotoxic damage and it determines the presence and the extent of the chromosomal damage. The MN is formed due to DNA damage or chromosomal disarrangements. The MN has a close association with cancer incidences. In the new era, mobile phones are constantly gaining popularity specifically in the young generation, but this device uses radiofrequency radiation that may have a possible carcinogenic effect. The available reports related to the carcinogenic effect of mobile radiation on oral mucosa are contradictory. AIM: To explore the effects of mobile phone radiation on the MN frequency in oral mucosal cells. MATERIALS AND METHODS: The subjects were divided into two major groups: low mobile phone users and high mobile phone users. Subjects who used their mobile phone since less than five years and less than three hours a week comprised of the first group and those who used their mobile since more than five years and more than 10 hours a week comprised of the second group. Net surfing and text messaging was not considered in this study. Exfoliated buccal mucosal cells were collected from both the groups and the cells were stained with DNA-specific stain acridine orange. Thousand exfoliated buccal mucosal cells were screened and the cells which were positive for micronuclei were counted. The micronucleus frequency was represented as mean±SD, and unpaired Student t-test was used for intergroup comparisons. RESULTS: The number of micronucleated cells/ 1000 exfoliated buccal mucosal cells was found to be significantly increased in high mobile phone users group than the low mobile phone users group. The use of mobile phone with the associated complaint of warmth around the ear showed a maximum increase in the number of micronucleated cells /1000 exfoliated buccal mucosal cells. CONCLUSION: Mobile phone radiation even in the permissible range when used for longer duration causes significant genotoxicity. The genotoxicity can be avoided to some extent by the regular use of headphones.